Updates for Healthcare Providers
We are the Medicare Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome!
KEPRO is currently experiencing a high call volume. We understand that there have been delays in reviews as well as wait times for phone calls. Due to technical challenges with government-furnished computer systems and for provider ease, KEPRO will temporarily use a different fax number. Please pay close attention to the return fax number listed on the Medical Record Request documentation.
The Centers for Medicare & Medicaid Services instituted a new data entry system, which is not able to provide the necessary data for the online Case Status Update tool. Therefore, the online tool was discontinued on June 8, 2019.
Our staff is continuing to work hard to process all reviews and provide determinations, and we appreciate your patience during this transition period.
bfcc-qio changes that require action by healthcare providers
KEPRO has been the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) in 33 states and the District of Columbia for the past five years and was recently awarded a new five-year contract by the Centers for Medicare & Medicaid Services (CMS) covering different states.
Effective June 8, 2019, KEPRO is the BFCC-QIO in those states that are shaded in the map below. See the table below for toll-free phone numbers.
As the BFCC-QIO, KEPRO will assist Medicare beneficiaries with quality of care complaints, hospital discharge and service termination appeals, and Immediate Advocacy.
If your facility is not in one of the shaded states below, Livanta is your BFCC-QIO effective June 8, 2019. These providers will need to update their appeals notices with Livanta's information.
KEPRO will be continually updating this page with additional contact information, so check back frequently.
temporary pause of bfcc-qio short stay and higher weighted diagnosis-related group reviews
CMS has temporarily paused the performance of both Short Stay reviews and Higher Weighted Diagnosis-Related Group (HWDRG) reviews by the BFCC-QIOs. Short Stay reviews and HWDRG reviews stopped for a brief time on May 8, 2019.
CMS took this action to procure a new BFCC-QIO contractor. Two BFCC-QIOs have done HWDRG reviews since 2014 and Short Stay reviews since 2015 for all 50 states and 3 territories. Going forward, Short Stay reviews and HWDRG reviews will resume with a single organization performing reviews on a national basis. CMS anticipates a contract award to be issued by the 3rd quarter of calendar year 2019.